Individual provider Active NPI

Andrea Lynn Trautwein, MA

  • Marriage & Family Therapist
  • Louisville, KY
National Provider Identifier
1215750435
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
281352 Issued in KY
Practice address
4010 Dupont Cir
Louisville, KY 40207-4812
Phone
(502) 694-0303
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 281352 KY Primary

Addresses

Primary practice location

4010 Dupont Cir
Louisville, KY 40207-4812

Mailing address

15905 Taylorsville Rd
Fisherville, KY 40023-9799
Phone (502) 657-8517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260420000432 KY Practitioner - Marriage and Family Therapist 6305312182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4010 Dupont Cir
Louisville, KY 40207-4841

4010 Dupont Cir
Suite 582
Louisville, KY 40207-4888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
281352KYMDMarriage & Family Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1215750435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15905 TAYLORSVILLE RD",
            "city": "FISHERVILLE",
            "state": "KY",
            "postal_code": "400239799",
            "telephone_number": "502-657-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-694-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUTWEIN",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "281352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.